16 profee coding auditor jobs found

Datavant is seeking a Profee Auditing Specialist to conduct coding audits and ensure compliance within the healthcare sector. This fully remote position requires 5+ years of experience in Professional Fee coding, with a strong emphasis on customer service and leadership skills. The ideal candidate will have a CPC certification and experience with software such as Epic and Cerner, contributing to healthcare data solutions that improve health outcomes. #J-18808-Ljbffr

Summary This position is located in the Health Information Management (HIM) Section at the Central Virginia VA Medical Center. MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. These coding practitioners analyze and abstract patients' health records and assign alpha-numeric codes for each diagnosis and procedure Responsibilities Basic Functions: Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Reviews assigned codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural...

Job Title: Medical Biller (Medicaid & MCO - Behavioral Health) Full-time Office Address: 20116 Ashbrook Pl #100 Ashburn, VA Compensation: USD 25 - USD 28 - hourly Position Summary The Medicaid & MCO Biller is responsible for accurate and timely submission, tracking, and reconciliation of claims for services billed to DC Medicaid and Managed Care Organizations (MCOs). This role ensures compliance with District of Columbia Department of Health Care Finance (DHCF) regulations and payer‑specific billing requirements while supporting revenue cycle efficiency. Eligibility & Authorization Verification Verify Medicaid eligibility using systems such as DC Access System or other payer portals. Confirm MCO enrollment and service coverage prior to claim submission. Track and manage prior authorizations and limitations. Claims Submission & Processing Submit clean claims to DC Medicaid and MCOs (e.g., AmeriHealth Caritas DC, MedStar Family Choice DC, Wellpoint, HSCSN)....

***To be considered for the role, you must permanently reside in one of the following states: Alabama, Arkansas, Florida, Georgia, Kentucky, Kansas, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Texas, Virginia, or West Virginia*** The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding process of new auditors. The Senior Compliance Auditor supports the audit supervisor with the development and maintenance of the quarterly audit work plan and audit workflow processes. The Senior Compliance Auditor recommends changes to improve business operations by using professional judgement and knowledge of best practices. This position contributes to special projects, as applicable. The Senior Compliance Auditor performs documentation/chart audits on inpatient and outpatient records, and to provide analysis of the records (provider and facility)...

Careers With Purpose Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Job Summary Responsible for conducting internal audits and monitors to ensure that the organization’s processes and operations are in compliance with laws, corporate guidelines, best practices, and contractual agreements. Knowledgeable of general audit concepts and techniques, including the type of audits, the approaches and processes, and the subsequent activities as they relate to internal audits. Demonstrates the ability to interpret Federal rules and regulations. Demonstrates the ability to research regulation from various data sources. Demonstrates an advanced knowledge and skill in analyzing patient records to identify non-conformances in Current...

Posting Details Posting Summary Working Title Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Role Title Role Code FLSA Exempt Pay Band UG Position Number 295A0003 Agency Tidewater Community College Division Tidewater Community College (Div) Work Location Suffolk - 800 Hiring Range Commensurate with qualifications and experience. Emergency/Essential Personnel No EEO Category I-Faculty Full Time or Part Time Part Time Does this position have telework options? -Telework options are subject to change based on business needs- No Does this position have a bilingual or multilingual skill requirement or preference? Work Schedule Varies Sensitive Position No Job Description Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is...

Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Tidewater Community College's Workforce Solutions Department seeks an experienced Medical Coder/Auditor to lead a hands-on Certified Professional Medical Auditor (CPMA) exam–preparation course. This position is an adjunct instructor position in the college's non-credit program under Workforce Solutions. This program includes both continuing education for professional development and industry recognized credential attainment, which may be offered Asynchronously, at TCC campuses and other convenient locations throughout the community. The CPMA instructor will prepare students to audit medical records and ensure coding accuracy and compliance. Emphasis is placed on healthcare regulations, documentation review, and revenue integrity. The candidate will deliver engaging CPMA-focused instruction using real-world coding scenarios, chart reviews, and denial analysis. The instructor must be...

Title: Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Agency: Tidewater Community College Location: Suffolk - 800 FLSA: Exempt Hiring Range: Commensurate with qualifications and experience. Full Time or Part Time: Part Time Additional Detail Job Description: Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is the largest provider of higher education and workforce services in Hampton Roads, enrolling nearly 25,000 students in 2024-25. Founded in 1968 as a part of the Virginia Community College System, Tidewater Community College (TCC) services South Hampton Roads with 4 campuses in Chesapeake, Norfolk, Portsmouth, and Virginia Beach, 7 regional centers and 2 important cultural institutions. The college had 3,399 graduates in 2024-2025, 40 percent of whom pursued degrees...

Job Title Help Basic Functions Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Reviews assigned codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or evaluation and management (E/M) code to ensure ethical, accurate, and complete coding. Applies guidelines specific to certain diagnoses, procedures, and other criteria used to classify patients under the Veterans Equitable Resource Allocation (VERA) program that...

Overview Note: Please only apply to the specific job posting for which you have experience in the specialty. Duplicate applications will not be considered. Job Summary We are seeking a detail-oriented and knowledgeable Medical Biller and Coder for Podiatry Department to join our healthcare team. The ideal candidate will be responsible for managing the billing process, ensure accuracy in medical coding, and facilitating timely payments from insurance companies and patients. A strong understanding of podiatry-specific medical terminology, coding systems, and collections is essential for success in this role. Responsibilities Process medical billing claims accurately and efficiently using appropriate coding systems such as ICD-10 and ICD-9, CPT, and HCPCS specific to podiatric procedures. Review patient records to ensure all necessary information is included for billing purposes. Verify insurance coverage and benefits prior to submitting claims to ensure proper...

A healthcare services provider is seeking an Inpatient Medical Coding Auditor to work remotely. This role involves extracting clinical information from medical records and ensuring proper reimbursement for inpatient hospital claims. Ideal candidates will have at least four years of experience with RHIA, RHIT, or CCS certifications. Benefits include competitive medical, dental, and vision packages along with a 401(k) plan. This position is vital for maintaining accuracy in provider contract payments and improving overall healthcare efficiency. #J-18808-Ljbffr

CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix’s autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Overview Reporting to the Manager, Medical Coding & Audit, as a Medical Coder II or III, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers’ coding quality expectations. The Medical Coder II or III will be responsible for leveraging their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Newport News, VirginiaFOR APPLICATION REVIEW - PROVIDE YOUR AAPC CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUMEThis position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA.Hours: Labor Pool (as needed)OverviewEnsures high quality documentation that is thorough, accurate and complete to ensure correct reimbursement capture. Assigns diagnostic and procedure codes to simple record types up to highly complex record types. Contributes to the proper management of health information through consistent and accurate code assignment processes adhering to all regulatory coding principles, rules and regulations.What you will doOrganizes and prioritizes assigned work to ensure that work is completed within the assigned time frame. Reviews charts and entire medical records, assigning ICD and CPT code combinations to each data element. Audits for documentation opportunities and queries clinical staff to fill in any gaps...

Company Overview Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra Health is looking for a Medical Coder-Inpatient to join our growing team. Job Summary: The Medical Coder is responsible for reviewing inpatient medical record documentation to ensure the accuracy, completeness, and...

Candidate should ideally be located in Norfolk, VA or Raleigh, NC Monro’s family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach.  Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company’s regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color.  Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry.  Do you have what it...